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  5. Kennedy Vision Health Center, LLC

Kennedy Vision Health Center, LLC

Company Details

Name: Kennedy Vision Health Center, LLC
Jurisdiction: Minnesota
Legal type: Limited Liability Company (Domestic)
Status: Active / In Good Standing
Date formed: 30 Jan 2004 (21 years ago)
Company Number: 3b7452bc-87d4-e011-a886-001ec94ffe7f
File Number: 775553-2
Registered Office Address: 1025 Evergreen Ln, Plymouth, MN 55441, USA
Principal Executive Office Address: 10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441–6200, USA
ZIP code: 55441
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2023 731695115 2024-07-01 KENNEDY VISION HEALTH CENTER, LLC 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621399
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2024-07-01
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-01
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2022 731695115 2023-07-07 KENNEDY VISION HEALTH CENTER, LLC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621320
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2023-07-07
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2021 731695115 2022-09-16 KENNEDY VISION HEALTH CENTER, LLC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621320
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2022-09-16
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2020 731695115 2021-09-28 KENNEDY VISION HEALTH CENTER, LLC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621320
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2021-09-28
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2019 731695115 2020-06-10 KENNEDY VISION HEALTH CENTER, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621399
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2020-06-10
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-10
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2018 731695115 2019-06-06 KENNEDY VISION HEALTH CENTER, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621399
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2019-06-06
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-06
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2017 731695115 2018-05-22 KENNEDY VISION HEALTH CENTER, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621399
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2018-05-22
Name of individual signing ANTHONY TRAV
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-22
Name of individual signing ANTHONY TRAV
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2016 731695115 2017-07-20 KENNEDY VISION HEALTH CENTER, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621399
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2017-07-20
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-20
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2015 731695115 2016-10-13 KENNEDY VISION HEALTH CENTER, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621399
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-13
Name of individual signing ANTHONY TRAVERSE
Valid signature Filed with authorized/valid electronic signature
KENNEDY VISION HEALTH CENTER 401(K) PROFIT SHARING PLAN 2014 731695115 2015-07-16 KENNEDY VISION HEALTH CENTER, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621399
Sponsor’s telephone number 7635458850
Plan sponsor’s address 10600 OLD COUNTRY ROAD 15, PLYMOUTH, MN, 55441

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing KATHIE KENNEDY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-16
Name of individual signing KATHIE KENNEDY
Valid signature Filed with authorized/valid electronic signature

Manager

Name Role Address
Anthony Traverse Manager 10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441–6200, USA

Agent

Name Role
David Kennedy Agent

Filing

Filing Name Filing date
Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic) 2018-01-01
Annual Reinstatement - Limited Liability Company (Domestic) 2007-01-17
Administrative Termination - Limited Liability Company (Domestic) 2006-01-11
Original Filing - Limited Liability Company (Domestic) 2004-01-30
Limited Liability Company (Domestic) Business Name (Business Name: Kennedy Vision Health Center, LLC) 2004-01-30

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Related by address

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Date of last update: 28 Dec 2024

Sources: Minnesota's Official State Website

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